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Six months after COVID-19, doctors fear what will come next



Six months. That’s all it took for a new virus to travel around the world and infect more than 10 million people, including 2.5 million in the United States.

That period of time could have been enough to slow down or even stop the spread of COVID-19, the disease caused by the new coronavirus. Some countries, such as New Zealand, have succeeded so far.

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But six months after the first report of a new emerging virus in Wuhan, China on December 31st, peaks are occurring in new cases in the United States and other countries around the world.

The World Health Organization marked six months on Monday since a group of mysterious pneumonia cases in China was reported with a warning that the pandemic is “accelerating”

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“We all want this to end. We all want to move on with our lives,” said WHO Director-General Tedros Adhanom Ghebreyesus in his opening statement. “But the harsh reality is: this isn’t even close to the end.”

The aggressive spread of coronavirus in the United States, particularly in the southern and western states, is a reality that many American health professionals face with humility and disgust as they look towards the second half of 2020. The doctors and public health experts interviewed hesitated when he was asked if they had any hope that the United States could pass COVID-19 in the next six months.

“I am discouraged and demoralized,” said Dr. Michael Saag, associate principal for global health at the University of Alabama in Birmingham. “When we compare our case numbers to almost all other industrialized countries, we are massing.”

At least 126,332 deaths had been reported in the United States, with 500,000 deaths worldwide.

COVID-19 is a respiratory virus, which means it spreads more effectively through sneezing, coughing, speaking and even singing. Staying at least 6 feet away from others and wearing face tissue in public can help reduce spread, experts say.

But the encouragement to wear masks has been inconsistent, especially from the United States government.

President Donald Trump refused to wear a mask in public settings, although he did wear one during a private tour of a Michigan factory several weeks ago. Only last weekend, Vice President Mike Pence publicly encouraged the use of masks.

“There is no time like the present for us to put together our records and have uniform messages from all public officials,” said Saag. “We have to start singing from the same sheet of music. Otherwise, we’re just sowing more division.”

Dr Tom Frieden, former director of the Centers for Disease Control and Prevention who is president of Resolve to Save Lives, a global public health initiative, said: “We are becoming, as a nation, a latecomer and a pariah.”

Despite months of partial blockades in the United States, there is concern that Americans simply haven’t taken COVID-19 seriously.

“They think that after” hospitalization on the spot “it is possible to return to normal,” said Dr. Colleen Kraft, associate general manager at Emory University Hospital in Atlanta. “People don’t take personal responsibility and don’t protect themselves daily.”

“Sorry. This thing is not going away.”

Saag warned of a “laissez-faire attitude”.

“I’m sorry,” he said. “This thing is not going away.”

COVID-19 + flu

In anticipation of the fall, coronavirus adds a worrying level of uncertainty to the 2020-21 flu season. According to the CDC, up to 62,000 people died from flu-related complications during the 2019-2020 season. More than 700,000 Americans were hospitalized with flu during that period.

Experts simply don’t yet know how the two viruses will interact.

“Could it be that if you were infected with the flu, then several days later infected with COVID, you could be protected from the worst of what COVID could do? Or would it be the other way around?” asked Dr. Gregory Poland, an infectious disease expert who is director of the vaccine research team at the Mayo Clinic in Rochester, Minnesota.

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Experts say the U.S. health system is not prepared for a simultaneous influx of COVID-19 and flu.

“We know that the flu will be present and this pushes our hospital systems to operate at a frenetic level,” said Crystal Watson, senior scholar at the Johns Hopkins Center for Health Security. “We will be very stressed out by the combination of COVID-19 and flu.”

Influenza vaccines, although less than 50% effective, will be strongly encouraged in the fall to alleviate the impact on health systems.

The second wave

While hospitals in states like Arizona, California and Texas are working to contain new cases of coronavirus, hospitals in the northeast are preparing for what could happen next.

Northwell Health in New York treated 17,000 COVID-19 cases in the spring. Now, the system is preparing for a possible second increase by making sure it has enough fans, drugs and staff.

“We are preparing for the worst, hoping to be wrong,” said Dr. Mangala Narasimhan, a pulmonologist who is regional director of intensive care medicine at Northwell Health.

“Given everything that’s going on in Florida and Arizona and the fact that New York gets flights from all over the world,” Narasimhan said, “things will go wrong here.”

The hospital system also focuses on the mental health of its staff members, working in counseling and extra rest days. Regardless of what’s expected in the fall, staff may never feel ready for a second wave in New York City hospitals.

“We have a lot of PTSD,” said Narasimhan. “None of us will ever feel that we are fully prepared.”

While there are still many unknowns – because some people who have been exposed do not have very mild symptoms or diseases, while others require hospitalization or die – scientists are working quickly to develop effective treatments and a vaccine. Dr Anthony Fauci, director of the National Institute for Allergies and Infectious Diseases, predicted a vaccine early next year.

“I am confident, based on the level of scientific investigation I see underway,” said Saag. “Over the past 35 to 40 years we have learned a great deal about viral infections. We are accumulating every ounce of energy and knowledge in an attempt to decipher what this virus does and how we can stop it. This gives me some hope.”

Everyone agreed that the world had to focus on a single enemy: the virus.

“This is not a party against another or a state against another,” Frieden said. “It’s about humans against a virus.”

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